If you've talked to your doctor about menopause, it's likely you've been offered HRT: hormone replacement therapy. However, there are also natural alternatives to consider.
Many in the medical profession see HRT as a solution for all symptoms of menopause - but there are drawbacks, and it's not the right choice for everyone.
The pros and cons of HRT
In short, HRT medication provides synthetic versions of the hormones that decline naturally during menopause, usually given in a combined form with oestrogen and progesterone.
Some women swear by it and have found relief from symptoms like night sweats, insomnia, continual hot flushes and vaginal dryness. However, when you stop taking HRT, you'll go through menopause again as your hormones decline.
HRT may also be prescribed if your doctor believes you are at risk of osteoporosis, due to the effects of oestrogen on supporting bone turnover. This is balanced against the findings of a few studies which suggest that HRT may increase your risk of ovarian and breast cancer. However, the absolute increase in risk is small. This is something to discuss with your GP based on your family and lifestyle history.
Natural alternatives to HRT
Omega 3 essential fatty acids
The signs of omega 3 deficiency are similar to many symptoms experienced during menopause: dry skin, fatigue, depression, and aching joints. Omega 3 essential fats also support hormone balance and have a lubricating effect in the body, so may help with vaginal dryness.3
Good food sources include oily fish (salmon, mackerel, herring, sardines, seafood and fresh tuna), nuts, seeds and green leafy vegetables. If you don't like fish, it's worth supplementing fish oil daily. Look for one with at least 200mg of EPA per daily dose.
For vegetarians, include flax and chia seeds in your daily diet, and look for a vegetarian omega 3 supplement.
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Phytoestrogenic foods (plant oestrogens)
Foods rich in phytoestrogens, or plant oestrogens, may help to moderate symptoms of menopause due to their effect on oestrogen receptors on the cell membrane. In cases where oestrogen levels are low, they lock on to receptors and stimulate a mild oestrogenic effect. Where there is an oestrogen excess, the phytoestrogens block cell receptors.
Foods rich in phytoestrogens include soybeans and other plant-based foods such as beansprouts, chickpeas, flaxseed, sesame seeds and wholegrains.
Milk thistle
The active ingredient in milk thistle is a bioflavonoid called silymarin, which can help to support hormonal balance through its protective action on the liver. Any excess hormones we have in our body are detoxified and excreted via the liver and gut, which makes milk thistle an excellent herb to help support hormonal balance.
Vitamin D
Many women are prescribed HRT as a prevention for osteoporosis, particularly if they have gone through an early menopause or have had a full hysterectomy. However, supporting bone density doesn't just rely on having the right hormones present. There are key nutrients too, of which one is vitamin D.
Vitamin D is essential for calcium absorption, and is made through the action of sunlight on the skin. The cloudy days common in Northern European countries mean it's difficult to get enough sun to make sufficient vitamin D, and our ability to absorb the vitamin decreases with age, so it's important to take a supplement. Alongside sensible sun exposure when the sun is out, supplement at least 10mcg of the D3 form, which is better-absorbed than D2.
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B vitamins
If you're experiencing stress, panic attacks, anxiety or depression, then B vitamins can be very supportive. Known as the 'stress nutrients', B vitamins help to support your nervous system, the production of your feel-good neurotransmitter serotonin, and help your adrenal glands to manage stress.
As the B vitamins work in harmony, it's best to choose a B complex that provides a range of B vitamins from B1 to B6, plus B12 and folic acid. Food sources of B vitamins include green leafy vegetables, meat, fish, eggs, dairy and fortified foods.